MEDICARE: MARCELLE SULEK M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207YP0228X	Pediatric Otolaryngology Physician	E8951	TX
2	207Y00000X	Otolaryngology Physician	E8951	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619974631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCELLE SULEK M.D.

Provider Business Mailing Address
First Line	:	6550 FANNIN ST
Second Line	:	SUITE 1701
City	:	HOUSTON
State	:	TX
Zip	:	77030-2717
Country	:	US
Telephone Number	:	713-798-8291
Fax Number	:

Provider Business Practice Location Address
First Line	:	6701 FANNIN ST
Second Line	:	SUITE 540
City	:	HOUSTON
State	:	TX
Zip	:	77030-2316
Country	:	US
Telephone Number	:	832-822-3245
Fax Number	:	832-822-3396

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	08/03/2011

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